Teaching Medical Students Consulting Skills
Transcript of Teaching Medical Students Consulting Skills
Teaching Medical Teaching Medical Students Consulting SkillsStudents Consulting Skills
Doris Young Professor of General Practice
University of Melbourne
Teaching students In The
GP clinic
The beginning of education lies in imitation, wherefore pick someone worth imitating.
Martin H. Fischer, MD 1940
Here I am not so much striving to teach, as I am encouraging you to learn.
Peter Mere Latham, MD 1850
To teach is to touch a life forever. John Chamberlin, MD, FAAP, FACP
It’s all in a day’s work!A GP’s diary
cuts, bruises, colds, check ups,births, deaths, contraception, hayfever,nerves, bedwetting, drug abuse,
loneliness, sore throats, tiredness, immunisations, repeat
prescriptions etc etc………..
Common comments from GP teachers
• ‘we have to make a living,we are running a business’…
• ‘having students slow me down’• ‘I don’t know what to teach’• ‘Patients don’t like to see a
student…. Sitting in’…
• You don’t need to ‘teach’Help them to learn
• All Students CAN do more
• All Students WILL do more
Effective clinical teacher
• Communicating expectations• Stimulating interest enthusiastically• Interacting skillfully with patients• Involve the learner in the teaching
process• Role modelling the desired
behaviours
Framing the Visit
• Time limit• How much to do (Hx and PE or
just Hx)• Goal for presentation
– I want a 3 minute presentation vs. I want a 1 minute consult presentation
Helping learners focus
• Ask the learner before they go in the room what they will focus on
• Ask them a question to get them thinking about a unifying diagnosis
• If you let them “get it”– They’ll learn- “aha” moments are
priceless– You’ll learn about their thought process– They will see you as a true teacher and
role model
One Minute Preceptor• Get a commitment
– What do you think is going on? What do you want to do?
• Probe for supporting evidence– What led you to that conclusion? What else did
you consider?• Teach general rules• Tell them what they did right and the effect it had• Correct mistakes
– Next time consider trying...
Efficiency strategies used by GP teachers
• Have the student write the note, provide health education
• Summarize the patient’s history for the student• Have the student present in front of the patient• Tell the student how far to go with the PE• Give the student specific feedback• Set limited goals for the student prior to seeing
the patient
Priming the Learner: Uncomplicated Patients
• Uncomplicated patient for “routine visit”– What screening or preventive issues are
important?• Common problem like “fatigue”:
– Let’s generate some differential diagnoses– What symptoms and signs should we look for?– What tests might help us? – Here is a short resource.
Priming the Learner: Complicated Patients
• Complicated patient with urgent issue– Differential in setting of chronic issues– How will we decide if this patient needs
to be hospitalized for this problem?• Complicated patient with multiple
issues– Please focus just on diabetes
management. What complications/problems should we worry about?
Make learning relevant and fun
• Should always be learner-centered– Literature “review”– Reflection on what went well/wrong– Teach me something– record review– Goal of the day
Do’s and Don’ts
• Do involve them• Do encourage them• Do keep them busy• Do challenge them• Do make their placement a
positive experience
Don’ts
• Don’t make them a wall flower• Don’t bore them• Don’t humiliate them• Don’t complain to them about
family practice• Don’t expect them all to love
family practice
ackowledgement
Teaching in your office:a guide to instructing medical
students and residents
Alguire, Dewitt,Pinsky, Ferenchick2001
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